How to Support a Colleague If You’re Concerned About Substance Use

Substance use is one of the most under-discussed issues in the workplace – even in organizations dedicated to behavioral health and recovery. According to the National Safety Council, more than 75% of adults with substance use disorder (SUD) are employed, yet many hesitate to seek support at work out of fear of stigma, judgment, or even career repercussions.

At Eleanor Health, we know that addiction is not a moral failing or a disciplinary issue – it is a chronic, treatable medical condition. But we also know that stigma often silences people when they most need community and care. So, what happens if you notice a colleague who may be struggling? How do you show concern without putting their job – or your relationship – at risk?

Why These Conversations Matter

Ignoring warning signs of substance use doesn’t make them go away. Instead, it can impact the individual, their family, their team, and even workplace safety. On the other hand, approaching with compassion and care can create a safe space for a colleague to take the next step toward support.

These conversations are not about “catching” someone or going straight to HR or leadership. They are about being human. For many people, a kind and non-judgmental outreach from a peer can be the spark that opens the door to recovery.

A Compassionate Approach: Four Key Steps

Dr. Nzinga Harrison, co-founder and chief medical officer at Eleanor Health, outlines a structure for having these sensitive conversations in her book UN-ADDICTION:

1. Lead with compassion, not judgment.
   Begin from a place of care. You might say: “I’m concerned about you and wanted to check in.”
   
2. Be specific about what you’ve noticed.
   Stick to one or two concrete examples rather than vague impressions. For instance: “I noticed you seemed really withdrawn in yesterday’s meeting and left early three times last week.”
   
3. Offer support and resources.
   Ask how you can help, and share resources if appropriate. “Is there anything I can do to support you? Here’s a resource I found that might be useful.”
   
4. Respect autonomy.
   Remember: it’s not your job to fix the situation. It’s your colleague’s choice whether to accept support. Success is measured by making the offer, not by controlling the outcome.
   

What HR and Leadership Can Do

Here at Eleanor Health, we talk about how colleagues can only do so much on their own – workplaces need to build systems of support:

• Modernize EAP offerings to include accessible, evidence-based addiction and mental health care.
  
• Train managers to recognize early warning signs and respond with empathy, not punishment.
  
• Create safe spaces like employee resource groups (ERGs) for mental health and recovery.
  
• Communicate confidentiality clearly so employees know they won’t be penalized for seeking help.
  
• Go beyond policy to create a culture where compassion is the norm. Work the culture into policies, ensuring that policies are rooted in compassion and support rather than discipline, so team members know they have a pathway to reach out when they need it.
  

When leadership invests in a supportive culture, employees feel safer to reach out – and colleagues feel more confident stepping into these conversations.

A Shared Responsibility

We each play a role in reducing stigma and building workplaces where recovery is possible. For colleagues, that means approaching one another with kindness and care. For HR and leadership, it means putting policies and programs in place that prioritize people over punishment.

If you’re concerned about someone at work, remember: a single compassionate conversation can plant a seed of hope. And if you’re in a position of leadership, your policies and practices can create the environment where those seeds grow.

Together, we can create workplaces where people don’t have to choose between protecting their careers and protecting their health.